One year after the FDA approved Yeztugo, the first twice-yearly injectable medication for HIV prevention, doctors are beginning to see what long-term adoption looks like beyond clinical trials.
For many people considering PrEP, remembering a daily pill has long been one of the biggest hurdles. Yeztugo replaces that routine with two injections a year, offering another option for people who want protection without a daily reminder.
To better understand how the rollout has unfolded, I spoke with Dr. Howard Grossman, chief medical officer at Spectrum Medical Care Center in Phoenix. His clinic has become one of the country’s early leaders in prescribing Yeztugo, with more than 225 patients already receiving the injectable and another 150 preparing to start treatment.
After a year of administering the medication, Grossman says the response has been exactly what he expected.
“I am not surprised in the least,” he told Gayety. “The convenience of an every six-month dose combined with the fantastic efficacy findings in studies far outweighs the concerns over injection site reactions for most patients. This is a gamechanger in HIV prevention.”
Word Of Mouth Has Fueled Early Interest
While the FDA approval generated headlines, Grossman says much of Yeztugo’s momentum has come from community conversations.
“There has been a great deal of excitement within the gay male community, where information about new HIV prevention options often spreads quickly through personal networks,” he said.
Spectrum Medical didn’t rely solely on organic buzz. Before Yeztugo became available, the clinic trained its PrEP navigation team so staff could answer questions and help patients compare every available prevention option.
The clinic also leaned into creative outreach. Alongside podcasts, blog posts, community events and patient education, Spectrum partnered with Joey Jay to produce a playful video explaining how Yeztugo works and why long-acting PrEP is generating so much interest.
Rather than steering patients toward one medication, Grossman says the goal has been to match people with the prevention method that best fits their lives.
The strategy appears to be paying off.
Why Patients Are Leaving Daily Pills Behind
For patients already taking oral PrEP, the transition has been surprisingly simple.
“Switching is quite easy once insurance coverage is obtained,” Grossman said. “It is liberating for many of our patients to not have to take a daily pill.”
He noted that many PrEP users are otherwise healthy young adults who take no other medication.
“For many, this may be the only medication they are taking,” he said. “Taking daily pills is a challenge for everyone and this delivery method really helps with adherence.”
That freedom has become one of Yeztugo’s biggest selling points.
Addressing Questions About The Injection
Like any injectable medication, Yeztugo raises questions before people decide whether it’s right for them.
Grossman says the most common concerns aren’t rooted in misinformation but in the injection itself.
“I think some people are concerned about injections in general,” he explained.
He also discusses injection-site reactions with every patient, including temporary nodules that can develop after receiving the medication. While those bumps typically resolve over time, people with very low body fat sometimes worry they could be noticeable.
“For most of us, that is not a concern,” he said. “But it is something I always discuss with patients.”
HIV Prevention Needs To Reach More Than One Community
Although gay and bisexual men remain a major focus of HIV prevention efforts, Grossman believes the next chapter requires reaching many more people.
He specifically pointed to sexually active women with male partners, who have historically received less education about PrEP despite benefiting from long-acting prevention.
“Long-acting HIV prevention offers women a highly effective option that puts prevention in their own hands,” he said.
He also wants to see stronger outreach to younger people who may underestimate their own HIV risk.
“If you speak to some of these folks about taking a daily pill, they will often reject the idea,” Grossman said. “But an injection twice a year that removes all the fear of getting infected? That can be a lot more attractive.”
The Bigger Challenge Isn’t The Medicine
Arizona reported 964 new HIV diagnoses in 2024, a 30% increase compared with a decade earlier. While Grossman believes medications like Yeztugo can help reverse that trend, he argues the bigger obstacle is making sure people stay connected to care.
“The real challenge to end the epidemic is now about reaching people facing huge life challenges, testing them, starting medications and then retaining them in care,” he said.
He cited retention rates in Phoenix as one of the area’s biggest concerns and called for stronger coordination between health departments, hospitals and community organizations.
Long-acting medications, he believes, could have an especially meaningful impact for populations that often face barriers to consistent care.
He pointed to people experiencing homelessness, whose medications are frequently lost or stolen, and sex workers, who often encounter obstacles accessing traditional health care.
“Long-acting injectables could provide them with a safety net to stop HIV infection in that high-risk community,” he said.
Grossman also expressed concern that proposed Medicaid cuts and reductions to HIV funding could make those efforts more difficult.
“In the effort to end HIV this will be devastating,” he said.
More Options Are On The Horizon
Yeztugo may be today’s headline, but Grossman expects it to be only the beginning.
He says researchers are already studying monthly oral medications, implants and injectable therapies that could last six months or even an entire year.
“I think we will see more tools for long-term prevention and also for long-term treatment,” he said. “Hopefully the competition will bring down prices and improve coverage.”
Ending HIV Is No Longer Just An Idea
For Grossman, the conversation around PrEP has shifted dramatically over the past decade. Instead of asking whether ending the HIV epidemic is possible, he believes the medical community already has the tools to make it happen.
“Even though we may not have a vaccine or cure, we do have the tools in our hands to end the HIV epidemic,” he said.
“If everyone living with HIV was on suppressive medication, and everyone at risk of acquiring HIV was on PrEP, the virus would disappear in one generation.”
He hopes that message encourages more people to learn about their prevention options, whether that means a daily pill, an injectable like Yeztugo or future treatments still in development.
“There is no one group that is enough to end this,” Grossman said. “It is time that we educate everyone about their personal risk and the ways to protect themselves.”
A year after Yeztugo entered the market, the biggest takeaway from my conversation with Grossman wasn’t simply that patients like having another PrEP option. It’s that choice itself may become one of the most powerful tools in HIV prevention. As more long-acting therapies arrive, the future of PrEP appears less about finding one solution for everyone and more about giving every person a prevention plan that fits their life.
